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A retrospective comparative study of recombinant human thrombomodulin and gabexate mesilate in sepsis-induced disseminated intravascular coagulation patients


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Title: A retrospective comparative study of recombinant human thrombomodulin and gabexate mesilate in sepsis-induced disseminated intravascular coagulation patients
Authors: Takazono, Takahiro / Nakamura, Shigeki / Imamura, Yoshifumi / Yoshioka, Sumako / Miyazaki, Taiga / Izumikawa, Koichi / Sawai, Toyomitsu / Matsuo, Nobuko / Yanagihara, Katsunori / Suyama, Naofumi / Kohno, Shigeru
Issue Date: Aug-2014
Publisher: 日本化学療法学会・日本感染症学会 / Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
Citation: Journal of Infection and Chemotherapy, 20(8), pp.484-488; 2014
Abstract: The novel biological agent recombinant human thrombomodulin (rhTM) has been used clinically in Japan to treat disseminated intravascular coagulation (DIC) since 2008. Previous studies have shown the efficacy of rhTM versus heparin therapy or non-rhTM therapy. We retrospectively evaluated and compared the efficacies of rhTM and gabexate mesilate (GM) in patients diagnosed with sepsis-induced DIC. From September 2010 to October 2012, patients with sepsis-induced DIC who were treated with rhTM (n = 13) or GM (n = 10) at Nagasaki Municipal Hospital were extracted. Patients receiving other anticoagulants in combination were excluded. Clinical information, laboratory data, Sequential Organ Failure Assessment (SOFA) scores, and DIC scores were obtained from the medical records. Mortality at days 7 and 30 after DIC diagnosis and changes in laboratory data and SOFA scores from days 1-7 were evaluated. The groups' clinical characteristics did not differ, except for the relatively higher C-reactive protein (CRP) levels in the rhTM group (P = 0.0508). The survival rates of the rhTM and GM groups on days 7 and 30 were 92.3%, 69.2% and 80%, 70%, respectively, both group indicated similar mortality. However, on day 7, the platelet counts, SOFA scores, and CRP levels significantly improved in the rhTM group; the platelet counts and SOFA scores did not improve significantly in the GM group. The platelet counts of the rhTM group significantly improved compared to the GM group (P = 0.004). Recombinant human thrombomodulin might be more effective for sepsis-induced DIC than GM.
Keywords: Disseminated intravascular coagulation / Gabexate mesilate / Recombinant human thrombomodulin / Retrospective study / Sepsis
URI: http://hdl.handle.net/10069/35338
ISSN: 1341321X
DOI: 10.1016/j.jiac.2014.04.010
Rights: © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. / NOTICE: this is the author’s version of a work that was accepted for publication in Journal of infection and chemotherapy. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of infection and chemotherapy, 20, 8, (2014)
Type: Journal Article
Text Version: author
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/35338

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